This application is a reapplication from the Brown Medical School to participate in the Cooperative Multi-Center Neonatal Research Network (RFA-HD-04-010). Abbot R. Laptook, MD will serve as the Principle Investigator, the Co-Investigator (Alternate) will be William Oh, MD, and the Follow-up Investigator will be Betty Vohr, MD. The primary teaching hospital of Brown for this application is Women and Infants' Hospital of Rhode Island (WIHRI). The Neonatal Intensive Care Unit (NICU) of WIHRI has a 60+ bed capacity and serves as the sole level III NICU in Southeastern New England. Adjoining WIHRI is Hasbro Children's Hospital which provides all needed specialized pediatric services for radiologic, surgical, and other subspecialty services. There are a number of considerations that justify Brown as one of the sites for the Network. First, Brown is the sole regional provider of perinatal services in Southeastern New England and thus provides a population that represents a geographic region. The stability of the number of deliveries, number of infants with a birth weight < 1500 grams, and referrals of high-risk pregnancies demonstrate a well-organized regional perinatal care system with established referral lines among the obstetric and pediatric communities. Second, the Brown site has a proven record within the Network. It has been a member institution since 1991 and continues to have a well-organized research team with a high percent of eligible infants enrolled in randomized trials, limited errors in conducting studies, complete data acquisition and an almost 90% follow-up rate. Third, the Brown site has an outstanding trio of investigators in Drs Laptook, Oh and Vohr, who are experienced in clinical research and provide expertise in multiple areas critical for the success of the Network. Finally, the Division of Neonatal-Perinatal Medicine at Brown has a strong commitment to clinical research. This commitment is reflected among the NICU staff at WIHRI who have come to expect patient participation in clinical research. The Brown site and WIHRI has made many important contributions to advance perinatal care over the last 30 years both as a single institution and in collaboration with other academic centers. Participation in the Neonatal Research Network provides the ideal forum to perform interventional and observational studies of neonates, and achieve a divisional and institutional goal to advance neonatal care though rigorous research and evidenced based medicine. [unreadable] [unreadable] [unreadable] [unreadable]